# The Causes and Consequences of Risky Prescribing

> **NIH NIH P01** · DARTMOUTH COLLEGE · 2021 · $268,501

## Abstract

PROJECT SUMMARY – PROJECT 2 
 
Prescription drugs have transformed patient care over the last several decades with stunning benefits, but their 
use has also conferred risks; this is especially true for the elderly. We propose to study three commonly-
prescribed but potentially risky groups of drugs (opioid analgesics, benzodiazepines, and non-benzodiazepine 
sedative hypnotics). We will explore how use of these drugs has changed over time and how their use, alone 
or in combination, is related to important health outcomes including falls, motor vehicle accidents, fractures and 
overdose events. Heightened susceptibility to the adverse effects of powerful drugs among near old, old, and 
very old adults makes study of these substances in aging populations essential to our understanding of their 
safety profile. But, these same drugs are important to high-quality, merciful management of pain, extreme 
anxiety and air hunger that can characterize end of life experience as well as many acute and chronic health 
conditions; underuse thus may be as burdensome as overuse. Our proposal has four aims: Aim 1: To describe 
patterns of risky drug receipt by the elderly, including opioid analgesics, benzodiazepines, sedative hypnotics. 
Aim 2: To measure outcomes related to risky drug receipt by the elderly. Aim 3: To explore clinician, health 
system, and external factors associated with potentially hazardous prescribing. Aim 4: To leverage natural 
experiments to identify plausible causes of hazardous prescribing patterns and plausibly causal effects of 
prescription drug use on adverse health events. Because we anticipate heterogeneous effects of these drugs 
in distinct populations, each aim will examine the overall population as well as sub-populations with feasible 
diverse vulnerabilities due to biologic factors; we will specifically study drug receipt, outcomes and predictors in 
groups defined by age, sex, race/ethnicity, poverty, long-term care residence and morbidities, including 
dementia and behavioral health conditions. This proposal addresses NIA priority research areas including 
“aspects of marijuana and prescription opioid and benzodiazepine use in adults aged 50 and older,” “health 
disparities and minority aging issues,” “interactions of comorbid conditions, therapies for these conditions, and 
the efficacy of interventions to optimize the balance of benefits and risks for the older patient with multiple 
conditions,” and, in our planned subgroup analyses, “social science research related to Alzheimer’s disease 
and related dementias.”

## Key facts

- **NIH application ID:** 10138940
- **Project number:** 5P01AG019783-19
- **Recipient organization:** DARTMOUTH COLLEGE
- **Principal Investigator:** ELLEN R. MEARA
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $268,501
- **Award type:** 5
- **Project period:** 2001-09-15 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10138940

## Citation

> US National Institutes of Health, RePORTER application 10138940, The Causes and Consequences of Risky Prescribing (5P01AG019783-19). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10138940. Licensed CC0.

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